ASSEMBLY HEALTH COMMITTEE

STATEMENT TO

ASSEMBLY, No. 1473

with committee amendments

STATE OF NEW JERSEY

DATED: MAY 1, 1997

      The Assembly Health Committee reports favorably and with committee amendments Assembly Bill No. 1473.

      As amended by the committee, this bill requires hospital, medical or health service corporations, commercial health insurers, dental plan organizations, dental service corporations, insurers who write automobile or workers' compensation insurance and health maintenance organizations (HMO's), and their subsidiaries that process health care benefits claims as third party administrators, to use standard enrollment and claim forms for paper and electronic transactions in connection with all policies and contracts for health care benefits within 12 months after the promulgation of regulations for such forms by the Commissioner of Banking and Insurance.

        In promulgating the regulations, the commissioner is required to consult with the Healthcare Information Electronic Data Interchange Policy Advisory Council and the boards of the New Jersey Individual Health Coverage Program and the New Jersey Small Employer Health Benefits Program and take into consideration the claim forms adopted by those programs. The commissioner will use national standards for electronic data interchange (EDI) as recommended by the advisory council and the program boards.

      The committee amended the bill to:

∙    include dental plan organizations, dental service corporations and insurers who write automobile insurance and workers' compensation insurance under the provisions of the bill;

∙    require the use of standard health care enrollment and claims forms within one year after the Commissioner of Banking and Insurance promulgates regulations to establish those forms;

∙    include within the provisions of the bill any subsidiary of a hospital, medical or health service corporation, health insurer, health maintenance organization, dental service corporation or dental plan organization, or an insurer who writes automobile or workers' compensation insurance, that processes health care benefits claims as a third party administrator;

∙    specify that the commissioner's standards are to be based on national standards for EDI and that the commissioner is to promulgate standards for health care enrollment and claims for use in both paper and electronic transactions;

∙    change the reference to the "Healthcare Information Electronic Data Interchange Policy Council" to the "Healthcare Information Electronic Data Interchange Policy Advisory Council" (which would be established by Senate Bill No. 50 (2R) Aca or Assembly Bill No. 1473 Aca of 1996, which were reported by the committee on this date); and

∙    change references to the "Commissioner of Insurance" to the "Commissioner of Banking and Insurance."

      This bill is part of a legislative package designed to effectuate the recommendations of the Healthcare Information Networks and Technologies (HINT) report to the Legislature under the joint auspices of Thomas Edison State College and the New Jersey Institute of Technology.

      As reported by the committee, this bill is identical to Senate Bill No. 49 (2R) Aca (LaRossa/Littell), which the committee also reported on this date.